Stages of Change fourth assignment, you will describe the stages of change, processes of change and preferred intervention(s) for your chosen behavior (min

Stages of Change fourth assignment, you will describe the stages of change, processes of change and preferred intervention(s) for your chosen behavior (minimum 2 pages).

Describe the 5 or 6 stages (i.e., precontemplation, contemplation, preparation, action, maintenance, and, if applicable, termination) of change and apply them to your health behavior.

Describe the processes of change that enable each stage change (i.e., consciousness raising, dramatic relief, environmental reevaluation, self-liberation, self-reevaluation, helping relationships, counterconditioning, reinforcement management, and stimulus control). Please refer to page 132, Table 7.2 for the Processes of Change That Facilitate Progression Between Stages of Change.

Describe the preferred intervention(s) for each stage.

Describe your level of confidence in your ability to change your behavior.

Use APA format for the in-text referencing and the reference list. You should be using reputable sources such as Centers for Disease Control (and other .gov resources) as well as the textbook and peer-reviewed articles.
Click on the “Transtheoretical Model or Stages of Change Assignment” link above to submit your assignment, as well as to get more information regarding the due date and grading rubric. Health Behavior
Behavior
A
ntecedent
B
ehavior
C
onsequence
Health Behavior
•
•
•
Those personal attributes such as beliefs,
expectations, motives, values, perceptions, and
other cognitive elements
Personality characteristics, including affective
and emotional states and traits
Overt behavior patterns, actions and habits that
relate to health maintenance, to health
restoration and to health improvement
Health Behavior
•
•
•
Health behavior is
something done, not
something done to you
Not always voluntary or a
part of one’s awareness
Includes analyses of
specific behaviors that have
impact on improvement or
recovery
Health Behavior
•
Personal attributes
influenced by/reflect
family structures and
processes, peer group
and social factors, and
societal , institutional, and
cultural determinants
The Scope of Health Behavior
The scope and tools of health behavior are
rapidly changing
New technologies to promote and track
healthy behaviors
1.
◼
e.g. wearables
Increased demand to facilitate behavior
change
2.
◼
e.g. childhood obesity reduction; hospital
readmission reduction
The Scope of Health Behavior
Multiple intervention types and levels
3.
Working with individuals, groups, and
communities
◼
Reliance on evidence-based methods
4.
Recommended over actions based on
intuition and experience
◼
5.
Increase in evaluations of theory-based
interventions
◼
Including systematic reviews and metaanalyses
The Scope of Health Behavior
Need to balance increasing innovations with
challenges to promoting health behaviors
Opportunities
Challenges
◼
Medical innovations
◼
Globalization
◼
Stronger evidence base
◼
Urbanization
◼
Increased access to tools for health promotion
◼
Industrialization
◼
Inequalities
◼
Billions spend on unhealthy lifestyle promotion
◼
Environmental health issues
The Scope of Health Behavior
◼
Professionals focus on:
◼
◼
Wide range of health concerns, including:
◼
HIV/AIDS
◼
Tobacco, alcohol, drug use
◼
Chronic illness
◼
Environmental conditions
Diverse settings:
◼
Schools
◼
Worksites
◼
NGOs
Dissemination of Information
◼
Major challenge of research is that results may
take too long to benefit people
◼
Need for increased dissemination of evidencebased interventions
◼
Exchange among theory, research, and
practice is most likely to produce positive
health behaviors
Kinds of Health-Related Behaviors
•
•
•
•
Preventive and Protective Behavior
Illness Behavior
Sick-role Behavior
Societal
Preventive and Protective
Behavior
•
•
“Actions undertaken by
persons who believe they are
well – and who are not
experiencing any signs or
symptoms of illness – for the
purpose of remaining well”
Primary, Secondary and
Tertiary levels of prevention
Preventive Behavior
•
•
•
Primary
Individuals who are well, not have signs of
illness
Engage in healthy behaviors to remain
well
• duration of sleep
• eating habits
Preventive Behavior
•
•
Eating Habits
• regularity, frequency,
amount eaten, eating
breakfast
Weight management
Preventive Behavior
•
•
•
•
•
•
Physical recreational activity
• swimming,/walking, working in the garden,
doing exercise, hunting/fishing
Consumption of alcoholic beverages
Not Smoking
Vitamins
Hand washing
Immunization
Preventive Behavior
•
•
Secondary
Focus on early detection / minimize
impact
• Cancer screening
• Heart disease
• Dental conditions
Protective Behavior
•
Protect health whether
medically approved or
not
• praying
• taking laxatives,
emetics, enemas
• cold showers
• hot baths
• massive vitamins
Illness Behavior
•
•
“Actions undertaken by persons who are
uncertain about whether they are well, who are
troubled or puzzled by bodily sensations or
feelings they believe are signs or symptoms of
illness, who want to clarify the meaning of these
experiences and thus determine whether they
are well, and who want to know what to do if
they are not”
Care-seeking or help-seeking
Illness Behaviors
•
•
•
•
Help-seeking from those
who may or may not be
recognized as being
health experts by society
Family and friends
Response to symptoms
culturally conditioned
Do nothing
Sick Role Behavior
•
“Actions undertaken by persons who have
already been designated as being sick,
either by others or by themselves”
Sick-Role
•
•
•
•
Already diagnosed as
being ill/sick
Adherence of medical
regimen
Limit activity (personal,
family, social
responsibilities)
Actions related to recovery
and rehabilitation
Societal Health Behavior
•
•
“what society does for the collectivity”
Health-related policies, regulations and
legislation
Health Behavior Research
•
•
Study health behavior as a
cause of disease/health
status
Analyze health behavior as
targets for systematic
interventions to produce
behavior change that may
lead to changes in health
status
Risk Behaviors
Behavior (High salt diet)
Illness or Disease (High Blood Pressure)
Lower Health Status (death
due to renal failure)
Targets for Change
Modified Health Behavior (quitting Smoking)
Decreased Risk of Illness or Disease
(lower risk of lung cancer)
Improved Health Status
(Larger Lung Capacity)
Health Behavior Research
•
Study health behavior as interesting in
their own right — as consequences or
outcomes of a variety of diverse personal
and social processes
Interesting in Their own Right
Causes, anchors, personal and social contexts
Health Behavior
Health Behavior Research
•
More needs to be done to
determine the most
effective methods for
achieving behavioral
change
•
Shows effective reduction in
risk factors
•
Should combine qualitative
and quantitative methods
•
“A dynamic exchange between theory,
research, and practice produces effective
health education.” (Glanz, Rimer & Lewis,
2003)
The Changing Context
•
•
•
•
•
•
Chronic diseases
Behavioral factors
Aging of the population
Escalating health care costs
New information about risks
Emerging epidemics
Recent Improvements
•
•
•
•
•
•
•
•
Control of Blood Pressure
Mean population blood cholesterol
Alcohol-related motor vehicle deaths
Deaths due to automobile crashes, falls and
drowning
Decline in use of tobacco products
Decline in sedentary lifestyles
Lower intake of dietary fats
Increased use of seat belts
Recent Improvements
•
•
•
•
•
•
•
•
•
Mammogram use
More worksite health promotion
More restrictive smoking policies
Significant reductions in infant mortality
Highest levels of childhood immunizations
Fewer teenage parents
Alcohol and other drug use is leveling off
Declines in death rates for coronary heart disease and
stroke
Significant advances in diagnosis and treatment of
cancer
Recent Challenges
•
•
•
•
•
•
More adults overweight
More adolescents sexually active
More teenage girls smoking
TB on the rise
AIDS
Lower health status for ethnic minorities
and those in poverty
Recent Challenges
•
•
•
Diabetes and other chronic conditions
Violence and abusive behavior
Mental disorders go undiagnosed and
untreated
Illness and Sick Role Behavior
Illness and Sick Role Behavior
Suchman’s Stages of Illness
Stage 1-Symptom Experience
Physical pain or discomfort
recognition that something is wrong
Role dysfunction, emotional
disturbance
Mechanic’s 10 social construction of
illness factors
1. Visibility
2. Perceived
seriousness
3. Disruption
4. Frequency or
persistence of
symptoms
5. Tolerance threshold
Mechanic’s 10 social construction of
illness factors
6. Information, knowledge
7. Perceptual needs (fear
leading to care or delay)
8. Competing priorities
9. Competing explanations
10.Availability of care
Stage 2-Assumption of the Sick
Role
•
Parson’s Sick Role
• Exemption 1-temporarily excused
from normal social roles
• Exemption 2-patient is not held
responsible for illness or getting
better
• Obligation 1-sick person must want
to get well
• Obligation 2-sick person must seek
competent help
Criticisms
•
Sick role doesn’t account for
sociodemographic or disease
variability
•
Applicable only to acute
illness
•
Applicable only to Dr.-patient
interaction in physician’s
office
•
Middle class bias
Medicalization
•
Sick role as an instrument of
social control expanded beyond
genuine medical expertise
•
expertise is not apparent
•
expertise is not applicable
•
Shift from immorality to illness;
weakness to illness;
undesirable to illness;
•
less stigmatizing and less
punitive
Medicalization
•
alcoholism, drug addiction, gambling
•
Before medicalization were more
stigmatizing and more punitive
•
leprosy, AIDS, cirrhosis of the liver
•
Hyperkinesis
•
bad kids become sick; less stigma;
more humane treatment that criminal
justice system;
•
removes from public scrutiny
Critical Thinking Question
◼ How
has medicalizing
alcoholism affected care
seeking among alcoholics?
Demedicalization
Homosexuality
De-institutionalizing
mental patients
Iatrogenesis
•
Clinical-physician or treatment
caused illness or injury
•
Social-trends in practice of
medicine alter social institutions
and interpersonal relationships
Cultural-medicine alters social
and cultural values, personal
values, etc.
•
Stage 3-Medical Care
Contact/Self-care
Stage 4Dependent/Patient
Care Role
Stage 5-Recovery and
Rehabilitation
The Changing Context of Health, Disease,
and Health Behavior
◼
Infectious diseases continue to be a threat in
many parts of the world
◼
◼
Malaria; diarrheal diseases; Ebola; MERS,
TB
Especially for poorest people worldwide
◼
Children, elderly, and those with compromised
immune systems are at increased risk
The Changing Context of Health, Disease,
and Health Behavior
◼
Past 20 years→ increased interest in improving
health through changes in lifestyle
◼
◼
◼
U.S. Healthy People goals
WHO Goals
Focus on behavioral and social determinants of
health
The Changing Context of Health, Disease,
and Health Behavior
◼
Increase in data and surveillance systems to track trends in U.S. health
◼
◼
Improving areas:
◼
Coronary heart disease mortality
◼
Blood pressure and cholesterol
◼
Alcohol-related motor vehicle accidents
◼
Tobacco use
Worsening areas:
◼
Overweight and obesity
◼
Diabetes
◼
Vaccine coverage
The Changing Context of Health, Disease,
and Health Behavior
◼
New technologies provide opportunities and
challenges for health behavior change
◼
Internet for health information
◼
Personal monitoring devices
◼
Differential access may widen disparities
◼
Need for theory-based interventions and
evaluations of new technologies
Health Behavior and Health Behavior
Change
Defining health behavior:
◼
the actions of individuals, groups, and
organizations as well as their determinants,
correlates, and consequences, including
social change, policy development and
implementation, improved coping skills, and
enhanced quality of life (Parkerson et al.,
1993)
Health Behavior and Health Behavior
Change
Defining health behavior:
◼
”Those personal attributes such as beliefs,
expectations, motives, values, perceptions,
and other cognitive elements; personality
characteristics, including affective and
emotional states and traits; and overt
behavior patterns, actions, and habits that
relate to health maintenance, to health
restoration, and to health improvement”
(Gochman, 1982; 1997)
Health Behavior and Health Behavior
Change
One respected definition of health behavior
proposed three categories from Kasl and Cobb
(1966)
1.
2.
3.
Preventive health behavior
Illness behavior
Sick-role behavior
Settings and Audiences for
HBC
Seven major settings relevant to contemporary
health behavior change:
1.
2.
3.
4.
5.
Schools
Communities
Worksites
Healthcare
Homes
6.
7.
Consumer
marketplace
Communications
environment
Settings and Audiences for HBC
◼
Interventions need to be designed based on
target audience
◼
◼
Health, cultural context, social
characteristics, beliefs, attitudes, values,
skills, past behaviors
Addressed as individuals, groups,
communities, and/or sociopolitcal entities
Settings and Audiences for HBC
Four dimensions used to characterize potential
audiences:
1.
2.
Sociodemographic
characteristics
Racial/ethnic
background
3.
Lifecycle stage
4.
Disease or at-risk
status
Progress in Research and Practice
◼
Studies to identify the most effective methods to
achieve health behavior change suggest:
◼
◼
Interventions must be carefully planned,
developed from strong formative research,
and be theory-based
Need for high quality study designs,
statistical methods, systematic reviews, and
meta-analyses
Progress in Research and
Practice
◼
Past 10-15 years has seen improvement
in high quality data collection process and
guidance
Need for integration of best available
knowledge from theory, research, and
behavioral change
References
Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2015). Health behavior: Theory, research, and
practice (5th ed.) San Francisco, CA: John Wiley & Sons.
Gochman, D. S. (1982). Labels, systems, and motives: Some perspectives on furture research.
Health Education Quarterly, 9, 167-174.
Gochman, D. S. (1997). Health behavior research: Definitions and diversity. In D. S. Gochman (Ed.),
Handbook of health behavior research: Vol. 1. Personal and social determinants. New York: Plenum
Press.
References
Kasl, S. V., & Cobb, S. (1996). Health behavior, illness behavior, and sick-role behavior: 1. Health
and illness behavior. Archives of Environmental Health, 12, 246-266.
Parkerson, G., Connic, R. T., Boadhead, W. E., Patrick, D. L., Taylor, T.R., & Tse, C. K. (1993).
Disease-specific versus generic measurement of health-related quality of life in insulin dependent
diabetic patients, Medical Care, 31, 629-637.

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